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5 Written questions

5 Matching questions

  1. explanation of benefits (EOB)
  2. diagnosis
  3. capitation
  4. medical necessity
  5. diagnosis code
  1. a a standardize value that represents a patien's illness, signs, and syptoms
  2. b adavance payments to a provider that covers each plan member's health care services for a certain period of time
  3. c paper document form a payer that shows how the amount of a benefit was determined
  4. d treament provided by a physycian to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, or its symptoms in a manner that is appropriate and provided in accordance with generally accepted standards of medical practice.
  5. e physician's opinion of the nature of the patient's illness or injury

5 Multiple choice questions

  1. a plan, program, or organization that provides health benifits.
  2. private or government organization that insures or pays for health care on the behalf of beneficiaries.
  3. .managed care network of health care providers who agree to perform services for plan members at discounted fees
  4. a managed health care system in which provides agree to offer heath care to the organization's members for fixed periodic payments from paln
  5. process of assigning standardize codes to diagnises and procedures

5 True/False questions

  1. practice management program (PMP)form that includes a patient's personal, employment, and insurance data needed to complete an insurance

          

  2. copaymenta small fixed fee paid by the patient at the time of an office visit.

          

  3. adjudicationseries of steps that determine whether a claim should be piad

          

  4. consumer-driven health plan (CDPH)a type of managed care in which a high-deductible/low-premium insurance plan is combined with a pretax saving account to cover out-of-pocket medical expenses, up to the deductible limit

          

  5. statementa small fixed fee paid by the patient at the time of an office visit.